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HomeMy WebLinkAboutHomestead_Higginson Reset Form f_ra��`y" T'~� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR • ( 'a : STANDARD i SUPPLEMENTAL DEDUCTION r - FORM ',1 f,+ State Form 5473(R20 I 12-24i1 HC1O /v 2 S 7wJ Prescribed by the Department of Local Government Finance INSTRUCTIONS See reverse side for filing instructions NOTE Telephone. Social Secunty driver's license. state identification and federal identification numbers are confidential under IC 6-1 1-12-37 CERTIFICATION STATEMENT I (We) 'Er J "rinklin --CO certify that I (we)occupied as my (our) pnnapal place of residence or am(are)b ying the(pl .2 c al,preperty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the Xis application is signed 1 (date of signature) I (Wei n A (are) buying under recorded contract (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation J Have a beneficial interest in the trust or the nght to occupy the property under the terms of a qualified personal residence trust Am(are)the shareholder, partner. or member of the entity that owns the property Recorder's Office 1Nhere Contract is Recorded Record Number Page PROPERTY DESCRIPTION County Township Taxing Distri ity town,township)� 'n ©2, '-- ,NV1 . Parcel Number Legal Description th properly in question Real Property Ll Annually Assessed Mobile Home(IC 6-1.1-7) If any portion of the residential structure or the land not exceeding one (1)acre that immediately surro n that structure is used to produce income,describe the use and portion of the property utilized to produce income 2 t� 0 oo7 2.____s 2 .. PROPERTY OWNED ELSEWHERE BY CLAIMANT State,County,and Township Is Claimant Vacati a omestead, Yes No Sign re of Claimant I hereby certify the above statements are true, correct, and complete pear, r ` _ A dress of Contact(number and street City slate and ZIP code) Address of Vacated Homestea if any(number and street city stare iP code) q qc d _s Ffi% -.,n- `1 . LtS ASSESSOR USE ONLY ASSESSED VALUE , HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land Not Exceeding One(1)Acre Immediately (1) Surrounding Residential Improvement - Other Land (2) Total Land (line 1 plus line 2) (3) Residential Improvements or Dwelling (4) Annually Assessed Mobile/ di? Manufactured Home Garage (5) \\' ) Other Improvements (6) f\•%I% , _g4ck. Total Improvements (Line 4 through Line 6) (7) l�`t Total Value (Line 3 plus Line 7) (8) l!" Signature of Assessor pa e i ?.-�'-re month year) I hereby certify the above is true, correct, and complete. Q�0 Venfying Action-Signature of Aud.icr 1y'�,Ta 5 fired(date month year) l? STANDARD DEDUCTION ALLOWANCE 20 Pay 20 Lesser of 60%of the assessed value of the homestead or 548.000 Notwithstanding any other provision the sum of the deductions provided in IC 6-1 1-12 to a mobile home that $ is not assessed as real property or to a manufactured home that is not assessed as real property may not exceed one-half(1/2)of the assessed value of the mobile meormanufactured home Signature of Audi_ 1qJ; , 3 Date S' ec (month da year) cit \I Ir2.-- 6 L DISTRIBUTION: Original-County Auditor File-Stamped Copy- axpayer 111 Page 1 of 3